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Screening children for mental health difficulties in school settings

02 December 2021
Volume 2 · Issue 6


Rates of probable mental health problems in children and young people in England are increasing while failure to identify and address mental health difficulties early in life affects individuals' long-term functioning and wellbeing.

Despite reported benefits of early identification and intervention, there is no school entry screening programme. The aim was to review the evidence for mental health screening and identification programmes based in schools against the UK NSC criteria.

We found mixed evidence of the feasibility and acceptability of screening and limited evidence on programmes' effectiveness and cost effectiveness. While there is evidence of effective interventions, there is work to do to enable timely and equitable access to mental health support.

Currently there is insufficient evidence to recommend a universal screening programme and any use of validated screening tools in schools should be accompanied by a clear pathway into early intervention services and a robust evaluation of the whole programme.

The 2017 British Mental Health of Children and Young People in England (NHS Digital, 2018) found that 1 in 8, 5–19-year-olds had at least one mental disorder; and the Wave 1 and 2 follow-up surveys suggest that mental health difficulties have been exacerbated by the coronavirus pandemic (NHS Digital, 2020; 2021). However, studies have found that fewer than one third of children and young people in need of support receive services (Dvorsky et al, 2014; Newlove-Delgado and Ford, 2020). Failure to address mental health difficulties early in life affects individuals' long-term functioning and wellbeing and may also generate significant societal costs related to increased health care usage, unemployment, and antisocial behaviours (Chief Medical Officer [CMO] 2012; 13).

The UK Government Green Paper on Children and Young People's Mental Health (Department of Health [DH] and Department for Education [DfE], 2017) sets expectations for schools to take a central role in the identification of and response to mental health difficulties (MHD). The DfE has issued non-statutory guidance to schools (DfE, 2018) and since 2018, local areas have been invited by NHS England and Improvement to establish mental health support teams (MHSTs), working with a cohort of local schools and pupils to provide early intervention on some mental health and wellbeing issues.

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